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The challenging diagnosis and treatment of duodenal diverticulum perforation: a report of two cases.

TitleThe challenging diagnosis and treatment of duodenal diverticulum perforation: a report of two cases.
Publication TypeJournal Article
Year of Publication2020
AuthorsMoysidis, M., Paramythiotis D., Karakatsanis A., Amanatidou E., Psoma E., Mavropoulou X., & Michalopoulos A.
JournalBMC Gastroenterol
Volume20
Issue1
Pagination5
Date Published2020 Jan 08
ISSN1471-230X
KeywordsAnti-Bacterial Agents, Conservative Treatment, Diagnosis, Differential, Digestive System Surgical Procedures, Diverticulum, Duodenal Diseases, Duodenum, Female, Humans, Intestinal Perforation, Middle Aged, Treatment Outcome
Abstract

BACKGROUND: The duodenum is a common site for diverticulum formation. Most of the duodenal diverticula are asymptomatic, incidental findings. Perforation is a rare but potentially lethal complication of duodenal diverticular disease. Surgery remains the mainstay of treatment for perforated duodenal diverticula. In recent years, a few cases were successfully managed either conservatively or with endoscopy.
CASE PRESENTATION: We present two cases of female patients treated in our department for duodenal diverticulum perforation. The first case was treated surgically with a diverticulectomy. The second case was managed conservatively with bowel rest and intravenous antibiotics. Both patients had an uncomplicated postoperative course and were discharged home.
CONCLUSIONS: Both surgical and conservative treatments are viable options for a perforated duodenal diverticulum in selected patients. Patients with a contained duodenal diverticular perforation can be managed conservatively at the outset. Possibly, the introduction of a classification system for duodenal diverticulum perforation may help clinicians in making essential therapeutic decisions.

DOI10.1186/s12876-019-1154-2
Alternate JournalBMC Gastroenterol
PubMed ID31914931
PubMed Central IDPMC6951008

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